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Ovarian Vein Syndrome


Presentation

  • In this report, we describe an unusual presentation of the syndrome successfully treated with laparoscopic techniques. The patient presented with a 12-month history of right flank pain and a right abdominal mass.[ncbi.nlm.nih.gov]
  • Patients present with lumbar pain or renal colics due to a compression of the ureter between the external iliac artery and a dilated ovarian vein.[ncbi.nlm.nih.gov]
  • We report two cases of ovarian vein syndrome whose presenting feature was lumbar pain.[ncbi.nlm.nih.gov]
  • Surgery is the first line treatment when clinical symptoms are present and, in our opinion,laparoscopic surgery is the best approach to treat this pathology.[ncbi.nlm.nih.gov]
  • It may present as an acute or chronic disease, typically affecting young, multiparous women.[ncbi.nlm.nih.gov]
Asymptomatic
  • Following treatment by percutaneous coil embolization of the corresponding ovarian vein, the symptoms rapidly improved and the patients are asymptomatic at 8 and 21 months follow up.[ncbi.nlm.nih.gov]
  • At 3-months follow-up, the patient was completely asymptomatic without evidence of obstruction. Ovarian vein syndrome remains a rare diagnosis of exclusion.[ncbi.nlm.nih.gov]
  • In a follow-up of nine months the patient remained asymptomatic. Urine cultures repeated every three months were negative and there were no radiologic signs of ureteral obstruction.[ijcasereportsandimages.com]
  • Symptoms do vary widely between individuals with asymptomatic patients (no symptoms or discomfort) not requiring treatments. Ovarian vein incompetence can be a cause of varicose veins in the leg.[melbourneendovascular.com.au]
  • […] normal laparoscopy for chronic pelvic pain have revealed dilatation of the major pelvic veins and congestion in the ovarian plexuses and broad ligaments in more than 80% of cases. 7 Furthermore, ovarian vein dilatation has been observed in up to 10% of asymptomatic[phlebolymphology.org]
Recurrent Urinary Tract Infection
  • The clinical features have no specificity including an acute or chronic lumbar pain, recurrent urinary tract infection, and frank hematuria [2] [9] [13]. Typically, the pain is exacerbated in premenstrual period or during pregnancy [7] [4].[ijcasereportsandimages.com]
Plethora
  • The term pelvic congestion syndrome (PCS) is a complex of symptoms summarized, which essentially refer to lower abdominal pain in women in connection with displayable venous plethora.[vbderma.com]
Colic
  • CONCLUSION: Ovarian vein syndrome in pregnancy can lead to violent colic pain and can become complicated by accompanied pyelonephritis.[ncbi.nlm.nih.gov]
  • After section of the vein, exclusively anterograde peristalsis was observed, and at 3 month follow-up, the patient was free of right side colics.[ncbi.nlm.nih.gov]
  • Patients present with lumbar pain or renal colics due to a compression of the ureter between the external iliac artery and a dilated ovarian vein.[ncbi.nlm.nih.gov]
  • Conclusion Ovarian vein syndrome in pregnancy can lead to violent colic pain and can become complicated by accompanied pyelonephritis.[link.springer.com]
  • Risk factors: (1) pregnancy (2) other conditions associated with congestion of an ovarian vein (3) aberrant course to an ovarian vein (malposition) Clinical features: (1) flank or lumbar pain (2) renal colic (3) recurrent episodes of pyelonephritis Imaging[meducator3.net]
Right Flank Pain
  • The antiperistalsis was related to the patient intermittent right flank pain.[ncbi.nlm.nih.gov]
  • The patient presented with a 12-month history of right flank pain and a right abdominal mass. The preoperative evaluation revealed renal malrotation, hydronephrosis, decreased renal function, and presumed ureteropelvic junction obstruction.[ncbi.nlm.nih.gov]
  • A 41-year-old woman complained with right flank pain, especially with a recumbent position. OVS was diagnosed and ureterolysis and ovarian vein resection were successfully performed, using retroperitoneoscopic techniques.[ncbi.nlm.nih.gov]
  • flank pain coinciding with menstruation, recurring UTI and exacerbation with progesterone Treatment Surgical.[medical-dictionary.thefreedictionary.com]
  • Case 1: A 43-year-old female with obstetric history of three gestations, presented with a 24-month history of recurrent right flank pain. She denied having a history of gross hematuria or urinary tract infection.[ijcasereportsandimages.com]
Abdominal Mass
  • The patient presented with a 12-month history of right flank pain and a right abdominal mass. The preoperative evaluation revealed renal malrotation, hydronephrosis, decreased renal function, and presumed ureteropelvic junction obstruction.[ncbi.nlm.nih.gov]
  • The typical patient with ovarian vein thrombosis (ie, thrombophlebitis) presents with pelvic pain, fever, and a right-sided abdominal mass. [7] The combination of anticoagulant and intravenous (IV) antibiotic therapy is the treatment of choice.[emedicine.medscape.com]
Pelvic Mass
  • The first finding is usually a pelvic mass noted on pelvic examination. However, if the patient is obese or has difficulty relaxing and cooperating with the examiner, the mass may not be felt.[medical-dictionary.thefreedictionary.com]
Unilateral Ptosis
  • ptosis of the kidney are thought to be contributing factors leading to intermittent ureteral obstruction and recurring bouts of pain and pyelonephritis. ovarian vein 'syndrome' A clinical complex due to an enlarged and tortuous right ovarian vein with[medical-dictionary.thefreedictionary.com]
Flank Pain
  • The antiperistalsis was related to the patient intermittent right flank pain.[ncbi.nlm.nih.gov]
  • The patient presented with a 12-month history of right flank pain and a right abdominal mass. The preoperative evaluation revealed renal malrotation, hydronephrosis, decreased renal function, and presumed ureteropelvic junction obstruction.[ncbi.nlm.nih.gov]
  • A 41-year-old woman complained with right flank pain, especially with a recumbent position. OVS was diagnosed and ureterolysis and ovarian vein resection were successfully performed, using retroperitoneoscopic techniques.[ncbi.nlm.nih.gov]
  • pain coinciding with menstruation, recurring UTI and exacerbation with progesterone Treatment Surgical.[medical-dictionary.thefreedictionary.com]
  • Case 1: A 43-year-old female with obstetric history of three gestations, presented with a 24-month history of recurrent right flank pain. She denied having a history of gross hematuria or urinary tract infection.[ijcasereportsandimages.com]
Chronic Pelvic Pain Syndrome
  • Bachar GN, Belenky A, Greif F, et al. (2003) Initial experience with ovarian vein embolization for the treatment of chronic pelvic pain syndrome. Isr Med Assoc J 5:843–846 PubMed Google Scholar 13.[doi.org]
  • Initial experience with ovarian vein embolization for the treatment of chronic pelvic pain syndrome. Isr Med Assoc J. 2003;5(12):843-846. Chung MH, Huh CY. Comparison of treatments for pelvic congestion syndrome.[aetna.com]
Cervical Motion Tenderness
  • Other features on physical examination that may point to the diagnosis include cervical motion tenderness and an engorged blue-looking cervix.[radiologykey.com]
Decreased Renal Function
  • The preoperative evaluation revealed renal malrotation, hydronephrosis, decreased renal function, and presumed ureteropelvic junction obstruction.[ncbi.nlm.nih.gov]

Workup

  • In addition, they have often gone through an extensive diagnostic workup and in many cases, the cause for their discomfort is difficult to find.[radiologykey.com]
  • After a standard workup and battery of tests and exams fail to lead to a diagnosis, many women are told that their symptoms are “all in their head.”[savannahvascular.com]
  • This clinical entity is often underestimated and patients suffering from pain related to pelvic varicosities undergo a long and inconclusive diagnostic workup before the exact cause of symptoms is recognized.[phlebolymphology.org]

Treatment

  • Conclusion Ovarian vein embolization using coils is a safe and effective therapeutic method for treatment of PCS. It is thought that surgical treatment should be considered in cases where embolization proves ineffective.[doi.org]
  • This treatment has largely superseded operative options.[en.wikipedia.org]
  • We report a case of Ovarian Vein Syndrome, describe its clinical symptoms and discuss its diagnosis and management including laparoscopic surgery treatment.[ncbi.nlm.nih.gov]

Prognosis

  • Although aggressive treatment in the early stages offers the best prognosis, detection before the malignancy reaches an advanced stage is difficult. Signs and symptoms become more apparent as the tumor grows.[medical-dictionary.thefreedictionary.com]
  • Signal characteristics T1 : seen as flow voids T2 : mostly high signal but but can vary dependent on velocities from low signal to iso signal GE : high signal Treatment and prognosis Treatment options include coil embolization of the gonadal vein: ovarian[radiopaedia.org]
  • .- portal vein embolization), the increased safety of liver surgery have gradually improved the outcome.Amplification of the human analogue of newly observed in breast and ovarian cancers and correlates with a poor prognosis (Slamon et al, Science 235[wevanoxovatiyed.j.pl]

Etiology

  • It is concluded that the etiology in this case was compression of the ureter by the enlarged ovarian vein, which had an increased blood flow from contralateral venous anastomose.[ncbi.nlm.nih.gov]
  • Etiology Pelvic congestion syndrome has a mixed etiology. The demands made on venous return by the constant hormonal changes associated with pregnancy leads to variable increases in intraluminal pressure.[radiologykey.com]
  • When used during the initial assessment of pelvic pain, it can be useful to rule out other etiologies of pelvic pain.[evtoday.com]
  • Pelvic congestion syndrome (PCS) is a poorly understood and often overlooked etiology of chronic pelvic pain.[clinicaladvisor.com]
  • ETIOLOGY The precise etiology of PVI is poorly understood. The underlying mechanism is reflux of blood in the pelvic and/or ovarian veins.[phlebolymphology.org]

Pathophysiology

  • Author information 1 Department of Surgery, Norfolk & Norwich University Hospital NHS Trust, Norwich, UK. hinabhutta@hotmail.com Abstract The Ovarian Vein Syndrome was first reported in 1964, yet its existence as a true pathophysiological entity remains[ncbi.nlm.nih.gov]
  • The pathophysiology of ovarian vein syndrome is still poorly understood.[ijcasereportsandimages.com]
  • Chronic dull pelvic pain, pressure, and heaviness Often associated with movement, posture, and activities that increase abdominal pressure Unilateral or bilateral Often asymmetric Physical examination findings Varicose veins and ovarian point tenderness Pathophysiology[learningradiology.com]
  • Krampfadern in den Beinen im Bein brennt » Arthrose und Krampfadern, was droht Krampfadern The Ovarian Vein Syndrome was first reported in 1964, yet its existence as a true pathophysiological entity remains controversial.[wevanoxovatiyed.j.pl]

Prevention

  • While specific measures to prevent ovarian cancer are not known, health care providers can encourage early detection by stressing the importance of regular gynecologic examinations and teaching women to recognize the signs and symptoms of ovarian tumors[medical-dictionary.thefreedictionary.com]
  • Science ‎ Pagina 305 - Silva P (1994) Effects of saline, mannitol, and furosemide to prevent acute decreases in renal function induced by ‎ Pagina 465 - Bennett NT, Schultz GS (1993) Growth factors and wound healing: part II.[books.google.it]
  • What we do know is that in normal veins, blood flows from the pelvis up toward the heart in the ovarian vein and is prevented from flowing backward by valves within the vein. When the ovarian vein dilates, the valves do not close properly.[vein.stonybrookmedicine.edu]
  • This causes the abnormal veins to scar down and collapse and prevents them from distending with blood.[savannahvascular.com]

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